Insulin resistance (IR) in type 1 diabetes drives multiorgan injury that extends far beyond glycemic dysregulation. Subcutaneous insulin delivery reverses the portal-to-peripheral insulin gradient, downregulating peripheral insulin receptors and promoting ectopic lipogenesis. Excess insulin drives concurrent hepatorenal injury by promoting metabolic dysfunction-associated steatotic liver disease and IR in the liver while inducing hyperfiltration and increased vascular permeability in the kidneys. Visceral adiposity and atherogenic dyslipidemia accelerate vascular aging, with subclinical cardiac dysfunction occurring in adolescents. We advocate shifting from glucocentric care to a holistic Cardiovascular-Kidney-Metabolic framework incorporating insulin sensitivity estimation, steatosis and cardiovascular screening, and targeted adjunctive pharmacotherapy.

A century after the discovery of insulin, people with type 1 diabetes continue to experience elevated cardiovascular risk and associated mortality, incompletely explained by dysglycemia and traditional risk factors. There is increasing recognition of the contributions of glycemic variability, insulin-related weight gain, insulin resistance and other hormonal disturbances to this risk, necessitating additional agents targeting these pathways. This article explores these mechanisms and provides an overview of current available agents. Finally, we highlight the sparsity of data on long-term outcomes and hard cardiovascular endpoints.

This retrospective real-world cohort study evaluated the effectiveness and safety of recombinant human growth hormone therapy in Chinese children with Noonan syndrome, with a predefined comparison between short-acting growth hormone and long-acting growth hormone during the first 2 years of treatment. Twenty children with Noonan syndrome were included; 16 were boys, and the median age at recombinant human growth hormone initiation was 5.55 years. The baseline height standard deviation score was-3.01. During the first 2 years, 10 patients received short-acting growth hormone and 10 patients received long-acting growth hormone. The median height standard deviation score increased to-2.20 after 1 year and-1.84 after 2 years, with significant longitudinal improvement over time. The cumulative change in height standard deviation score did not differ significantly between short-acting growth hormone and long-acting growth hormone at year 1 (0.58 vs. 0.71) or year 2 (1.01 vs. 1.30). First-year growth velocity was comparable between groups, whereas the apparent second-year difference was no longer significant after excluding short-acting growth hormone-treated patients who entered puberty and received adjunctive therapy. Among 16 patients with PTPN11 variants, the median cumulative change in height standard deviation score was 1.20 and 56.3% achieved an HtSDS of above-2 standard deviation score at the last follow-up. No diabetes mellitus, malignancy, new cardiovascular events, intracranial hypertension, or slipped capital femoral epiphysis occurred. Insulin-like growth factor-1 standard deviation score elevations were transient. Recombinant human growth hormone therapy was associated with sustained linear growth in children with Noonan syndrome, and short-acting growth hormone and long-acting growth hormone showed broadly comparable short-term efficacy under regular safety monitoring.

Detailed assessments of euthanasia rates of dogs with diabetes mellitus in Australian primary care practice and evaluation of associated risk factors have not been performed. Study objectives were to describe the euthanasia timing in this population and identify patient characteristics at diagnosis that increased the probability of euthanasia.

Records of dogs diagnosed with diabetes mellitus in primary care practice (n = 2078) during 2008 to 2017, inclusively, were sourced through VetCompass Australia. For cases that were euthanised, reasons were attributed to being related to diabetes mellitus or not. Time to euthanasia post-diagnosis was described using Kaplan-Meier survival curves. A Cox proportional hazards regression model was developed to identify risk factors for euthanasia following diabetes mellitus diagnosis.

The cumulative percentage of dogs euthanised for diabetes-related reasons at diagnosis, and within 6 and 12 months of diagnosis was 13%, 46% and 53%, respectively. During the first 12 months post-diagnosis, dogs that were entire [HR 1.9 (95% CI 1.6 to 2.3)], ≥10 years of age [HR 2.4 (95% CI 2.1 to 2.7)], female [HR 1.1 (95% CI 1.0 to 1.3)] and of breeds at higher risk of developing diabetes mellitus [HR 1.2 (95% CI 1.0 to 1.4)] had an increased daily hazard of euthanasia. Quality of life was the most frequently reported reason for euthanasia.

This study documents higher euthanasia rates among dogs with diabetes mellitus within the first year of diagnosis than previously reported. The findings help identify cases where additional owner support could be warranted.

The comorbidity of mental disorders and diabetes is on the rise, presenting a significant global public health challenge that gravely impacts the physical and psychological health of patients and presents obstacles to their effective management. The coronavirus disease 2019 (COVID-19) pandemic, in particular, aggravated these challenges owing to restrictions on in-person care. Artificial intelligence (AI) interventions have emerged as a promising solution to alleviate this burden. Thus, we conducted a scoping review to map the current evidence in the literature and provide a clear understanding of AI for mental disorders and comorbid diabetes.

This scoping review utilized the Arksey & O'Malley framework. Five electronic databases were systematically searched for studies published in the post-COVID era, focusing on AI-assisted approaches for individuals with mental disorders and comorbid diabetes.

Twenty-four studies were reviewed. Supervised learning algorithms were most commonly employed, with studies reporting positive performance metrics, while generative AI was essentially absent. The findings demonstrated promising outcomes in four functional domains: Risk assessment, Prediction, Diagnosis, and Personalised care. AI applications are predominantly at the capability stage of translation maturity, focusing mainly on model development and validation, with limited adoption in existing clinical workflows. Other limitations include little demographic reporting, limited external validation, scarce intervention-focused research, and ethical concerns.

AI shows promise in enhancing support for individuals with mental disorders and diabetes through targeted, data-driven strategies. Future studies should prioritize clinically integrated, patient-centred AI interventions and evaluate their effectiveness in improving functional outcomes, while addressing ethical considerations.

In the United States, colorectal cancer ranks as the third most commonly diagnosed malignancy and the second leading cause of cancer-related death in both men and women. Colorectal cancer incidence is rising among people under the age of 50 who account for an estimated 13% of cases. Colon cancer typically develops slowly over the course of five to ten years, so primary care physicians should maintain a high index of suspicion for early clinical indicators of potential malignancy to promote timely detection.

We report the case of a 40-year-old male with a history of morbid obesity (BMI 54 kg/m2), type 2 diabetes mellitus, and hypertension with isolated microcytosis (MCV 77.1 fL, hemoglobin 13.9 g/dL) and iron deficiency (iron 35 ug/dL, ferritin 68 ng/mL) during an annual wellness visit. The patient re-established care five years later and reported intermittent rectal bleeding that he owed to hemorrhoids. Labs were notable for iron deficiency anemia (hemoglobin 11.7 g/dL, MCV 69.2 fL, iron 17 ug/dL, ferritin 26 ng/mL). Colonoscopy revealed a partially obstructing infiltrating and circumferential tumor in the descending colon and several large, scattered pedunculated polyps. Biopsies confirmed invasive adenocarcinoma with intact expression of mismatch repair genes. Staging CT scan was unable to localize a colonic mass but identified clustered enlarged metastatic lymph nodes. Stage IIIb colon adenocarcinoma (cT3 cN1b cM0) was treated with neoadjuvant chemotherapy (mFOLFOX 6) followed by a left hemicolectomy eight months after the diagnosis with remission.

Iron deficiency anemia is a well-known clinical indicator for colorectal cancer. Any early signs of anemia including isolated microcytosis in men or post-menopausal women should be further investigated for gastrointestinal blood loss. With rising incidence of colorectal cancer in younger adults, laboratory abnormalities warrant thorough evaluation as they may be the only indicator of occult blood loss from malignancy.

This study explored the potential association between paclitaxel (PTX) and macular oedema (ME), a rare adverse event, through pharmacovigilance analysis using a large-scale spontaneous reporting database.

Disproportionality analysis of ME associated with PTX formulations, including nanoparticle albumin-bound PTX (nab‑PTX) was conducted using the Japanese Adverse Drug Event Report database on data collected during April 2004-June 2025. Multivariable logistic regression analysis was used to estimate adjusted reporting odds ratios (RORs) for ME. A positive signal was defined as a lower 95% confidence interval (CI) for the ROR exceeding 1.0 with at least three ME cases.

Among 585,738 reports, 123 involved ME. A significant signal was observed for overall PTX (adjusted ROR: 19.5; 95% CI: 13.5-28.3). By formulation, significant signals were identified for conventional PTX (adjusted ROR: 9.4; 95% CI: 5.5-16.1) and nab‑PTX (adjusted ROR: 47.0; 95% CI: 30.4-72.8). Multivariable logistic regression indicated significant signals for diabetes mellitus (adjusted ROR: 1.8; 95% CI: 1.2-2.9) and co-administration of prostaglandin analogue eye drops (adjusted ROR: 19.9; 95% CI: 8.6-45.7).

PTX formulations were associated with an increased reporting signal of ME. Notably, patients with diabetes mellitus and those using prostaglandin analogue eye drops may require closer ophthalmologic monitoring during PTX therapy.

Type 2 diabetes mellitus affects pregnancy and can lead to maternal complications. Women affected by diabetes during pregnancy have ongoing physical, psychological, and social needs until birth preparation and after childbirth. The Social Determinants of Health (SDoH) can have a greater impact on health outcomes than healthcare services or personal lifestyle choices alone. To date, no study has explored how women with type 2 diabetes experience life after childbirth. To help close this knowledge gap, the proposed study aims to: 1) Culturally adapt and translate the Postnatal Well-being in Transition scale into Thai. 2) Quantitatively describe the SDoH and postnatal well-being during the diabetes transition among Thai women with T2DM. 3) Explore Thai women's experiences regarding their SDoH, based on the mean scores of their postnatal well-being during the diabetes transition. And 4) Explore and analyze the impact of postnatal care on women with T2DM using a mixed-methods approach.

This is an explanatory sequential mixed-methods study protocol with two distinct phases. The first phase involves the translation of the study instrument, while the second phase focuses on data collection for the mixed-methods study. Data will be collected from 50 postnatal women with type 2 diabetes mellitus who have delivered a baby within the past six weeks. Participants will provide data on demographics, social determinants of health, and their postnatal well-being in transition. From this group, 12 women will be selected to participate in semi-structured, one-on-one interviews to gain a deeper understanding of their experiences. The study will use triangulation to integrate and validate the findings from both the quantitative and qualitative data sources.

Human Research Ethics Committee approval has been received from the Faculty of Medicine Ramathibodi Hospital, Mahidol University. The study findings will be reported in international journals.

Current understanding of insulin-related disordered eating behaviour is limited by inconsistencies in terminology and measurement. Prevalence of the behaviour and characteristics of individuals are unclear. How best to intervene and with whom is therefore unknown. This scoping review summarises existing knowledge as a first step to addressing the problem. Eligible sources investigated individuals with T1D restricting or inflating insulin with disordered eating motivations. Charted data included study aims, sample characteristics, measures, and key findings.

Samples converged on adolescent females in USA, Canada and western Europe. Numerous measures were used, few had received extensive validation. Prevalence estimates, and models of development and maintenance were inconsistent. The validity and generalisability of measures should be improved, particularly so that diverse perspectives (e.g., males, non-Western cultures), so far overlooked, are captured. Identity and social relationships appeared particularly important in the development and maintenance of insulin-related disordered eating behaviour and recovery, and could be a potential target for interventions.

Diabetic foot ulcer (DFU) is a severe and frequent complication of diabetes, posing a major burden on patient well-being. Although circular RNAs (circRNAs) have been implicated in DFU pathogenesis, many disease-relevant circRNAs remain uncharacterized. Herein, we aimed to identify key circRNAs involved in DFU and elucidate their underlying molecular mechanisms. CircRNA expression profiles of DFU and non-DFU skin tissues were retrieved from the Gene Expression Omnibus (GEO) dataset GSE114248, and weighted gene co-expression network analysis (WGCNA) was applied to screen for DFU-associated hub circRNAs, which were then verified and confirmed by combining RT-qPCR in clinical samples. A high-glucose (HG) - treated human epidermal keratinocyte model was used to mimic the diabetic wound environment. The function of hsa_circ_0006969 was assessed by CCK-8, wound healing, and Western blot assays. Further bioinformatics prediction combined with dual-luciferase reporter, RIP-qPCR, and rescue experiments were performed to clarify molecular mechanism of hsa_circ_0006969. We found that hsa_circ_0006969 was significantly upregulated in skin tissues of DFU patients and HG - treated human epidermal keratinocyte model. The in vitro functional experiments proved that knockdown of hsa_circ_0006969 alleviated high glucose‑induced inhibition of keratinocyte proliferation and migration. Mechanistically, hsa_circ_0006969 acted as a molecular sponge for miR-375, thereby upregulating the expression of USP10 and SCD. Rescue experiments further demonstrated that the protective effect of hsa_circ_0006969 silencing against high‑glucose damage was reversed by miR-375 inhibition, confirming the involvement of the miR-375/USP10/SCD axis. Collectively, our study reveals that hsa_circ_0006969 promotes DFU progression through the miR-375/USP10/SCD axis and may represent a novel therapeutic target for DFU treatment.